Anterior Cruciate Ligaments: Studying Updates in neuroCognition After Knee Manipulation
University of North Carolina, Chapel Hill
30 participants
Aug 1, 2025
INTERVENTIONAL
Conditions
Summary
This study will investigate whether knee joint manipulation can improve neurocognitive and neuromuscular performance in individuals with a history of anterior cruciate ligament reconstruction (ACLR). Recruitment will consist of 30 participants aged 18-35 who are 4 months to 5 years post-ACLR and demonstrate measurable reaction time delays. Using a within-subject pre-post design, participants will complete a battery of neurocognitive and neuromuscular assessments, including visuomotor reaction time and dual-task hop testing, before and after knee joint manipulation(s). The main questions the investigators aim to address are: Aim 1: Evaluate the feasibility, acceptability, and applicability of integrating knee joint manipulation into post-ACLR rehabilitation using the Implementation and Outcomes Framework. Aim 2: Determine preliminary efficacy of knee joint manipulation on neurocognitive performance in individuals with ACLR.
Eligibility
Inclusion Criteria7
- Provided informed consent prior to any study procedures that are performed.
- Are between the ages of 18 and 35.
- Have undergone ACLR surgery. All autograft and allograft types are accepted.
- Are 4-months to 10-years post-ACLR.
- Injured knee playing or training for sports (recreational or organized) or during physical activity.
- Have been cleared by a physician to return to activities and/or participate in this study.
- Are at least the minimally clinical important difference (MCID) above the normative reaction time average for our methods as established by previous literature in at least 1 reaction time task.
Exclusion Criteria5
- History of concussion in the past 3 months.
- The participant is pregnant.
- Have a neurological disorder, including epilepsy.
- Currently injured or have injured their lower extremity in the past 3 months.
- Had surgery on multiple ligaments when their ACL was injured.
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Interventions
A joint manipulation is defined as a manual treatment by a clinician that uses controlled force to improve joint function. For the purpose of this study, the terms manipulation and mobilization may be used interchangeably. The knee joint is specifically defined as the tibiofemoral articulation for the purpose of this study. All knee joint manipulation in this study will coincide with grade III or IV manipulations. This category coincides with evidence that mobilizations at or above grade III has the greatest impact on somatosensation and are most likely to produce a positive effect on neurocognitive function. Joint manipulation(s) will be delivered with a vector corresponding to the functional deficits found with manual joint palpation and will only occur with the involved ACLR knee. If both knees have experienced an ACL injury, the most recently injured knee will be manipulated.
Locations(1)
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NCT07058467